The UK death toll has risen past 12,000 deaths yet we know that this figure is not the complete picture as it excludes deaths occurring in other settings, including care homes. One care home told the Guardian a third of its residents had died, but deaths in care settings may not be captured in official figures for weeks after they occur. What does this mean for the UK’s true fatality count? How many Covid-19 deaths have there actually been in the UK so far? According to government figures, there were 12,107 deaths in the UK to 5pm on 13 April. The problem is that this figure only tells part of the story as it just covers hospital deaths that had been verified as of that date. What we do not know is how many more deaths there have been in the community and, most pressingly, in care homes. To give an indication of just how far out the daily figures are, as of 3 April the Department of Health and Social Care reported 4,093 coronavirus deaths in England and Wales. But the true figure – as revealed in the Office for National Statistics’ latest release – was at least 52% higher than was known at the time. Many of these deaths will have been reported in the days after 3 April, but others, including care home deaths, are counted separately and never make it into the daily government announcements. Put simply, the big death toll you hear every day is an undercount. How many deaths do we know to have occurred in care homes? The truth is we have no way of knowing for certain. The Guardian has revealed hundreds of deaths have occurred in care homes to date: two of the UK’s largest care home providers have reported 521 coronavirus deaths between them so far. The only official figures for care home deaths are those published by the ONS. These come out weekly, but there is a time lag because there is a delay between a death occurring and it being registered. The latest ONS figures provide a breakdown of the locations where 4,122 registered Covid-19 deaths took place. They show that 217 or 5% of deaths that occurred in England and Wales registered by 3 April actually happened in care homes. A further 136 deaths occurred in private homes, while 33 were in hospices. In its briefing note the ONS said, when all comparable data was taken into account, the number of deaths in England was about 15% higher than the NHS figures. However, the difference may well turn out to be higher as more deaths are registered. A recent report indicates that about half of all Covid-19 deaths could be happening in these settings in some European countries. How do other countries count care home deaths? We cannot directly compare care home deaths in the UK with those in other countries as there are different ways of recording these deaths. In Ireland, France and Germany, official data on deaths includes those in care settings. Of Irish deaths up until 11 April, 54% had occurred in care homes, according to the country’s chief medical officer. Figures released by the French public health authority show 45% of deaths took place in care homes. Removing care home fatalities from the French statistics reveals that the UK hospital death toll is higher than France’s – which government briefings have failed to note when stating that Britain is behind France in official cumulative death figures. Italy and Spain, by contrast, do not report deaths in care settings regularly. In Italy, best estimates were based on a survey of 10% of care homes in the country. The death rate in this sample was extrapolated to reach an estimate for all care homes, which suggests 53% of coronavirus deaths were happening in care. In Spain, estimates based on regional totals submitted to the government also suggest those in nursing homes accounted for more than half of deaths. What is the best estimate in the UK? The ONS figures are expected to be the gold standard as they will include deaths in both hospital settings and in the community. However, as the ONS bases its figures on death certificates, there are delays in its figures, meaning we may not see the true scale of the deaths for a number of weeks. Sarah Caul, head of mortality at the ONS, said in a blogpost explaining the methodology: “Numbers produced by ONS are much slower to prepare, because they have to be certified by a doctor, registered and processed. But once ready, they are the most accurate and complete information.” However, concerns have been raised regarding the death registrations on which the ONS figures are based. A whistleblower told Channel 4 News death certificates may be undercounting the true number of deaths, because coronavirus is not always correctly listed as a suspected cause.